대한두경부종양학회지 (Korean Journal of Head & Neck Oncology)
- 제7권2호
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- Pages.120-128
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- 1991
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- 1229-5183(pISSN)
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- 2586-2553(eISSN)
유리공장을 이용한 인두 및 경부식도 재건술
The Free Jejunal Autograft for the Hypopharynx and Cervical Esophagus Reconstruction
- 오경균 (원자력병원 이비인후과) ;
- 심윤상 (원자력병원 이비인후과) ;
- 이용식 (원자력병원 이비인후과) ;
- 박혁동 (원자력병원 이비인후과) ;
- 김기환 (원자력병원 이비인후과) ;
- 심영목 (원자력병원 흉부외과) ;
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조재일
(원자력병원 흉부외과)
- Oh Kyung-Kyoon (Department of Otolaryngology-Head and Neck Surgery, Korea Cancer Center Hospital) ;
- Shim Youn-Sang (Department of Otolaryngology-Head and Neck Surgery, Korea Cancer Center Hospital) ;
- Lee Yong-Sik (Department of Otolaryngology-Head and Neck Surgery, Korea Cancer Center Hospital) ;
- Park Hyuk-Dong (Department of Otolaryngology-Head and Neck Surgery, Korea Cancer Center Hospital) ;
- Kim Gi-Hwan (Department of Otolaryngology-Head and Neck Surgery, Korea Cancer Center Hospital) ;
- Shim Young-Mog (Department of Thoracic-Vascular Sugery, Korea Cancer Center Hospital) ;
-
Zo Jae-Ill
(Department of Thoracic-Vascular Sugery, Korea Cancer Center Hospital)
- 발행 : 1991.12.01
초록
Reconstruction of the pharynx and cervical esophagus presents a tremendous surgical challenge to the Head and Neck Surgeon. Because life expectancy of patients with advanced carcinoma of the hypopharynx, and cervical esophagus is limited, treatment must be aimed at palliation. A variety of techiques have been proposed over the years with none proving entirely satisfactory. These techiques include prosthesis; skin graft; cervical flaps; tubed cutaneous and myocutaneous chest flaps; visceral reconstruction with stomach, colon. and jejunum; and jejunal free autografts. Many factors dictate the best method of reconstruction in any given clinical situation. The goal of the surgery is a one-stage reconstruction of swallowing function with minimal morbidity to allow as short a hospital stay as posible. Nine patients underwent the free jejunal autograft reconstruction of the pharyngoesophagus after the ablative surgery for the advanced hypopharyngeal cancer. Postoperative complications included one perioperative death, two abdominal wound dehiscences, two neck hematomas, one carotid rupture, one funtional dysphagia, one late strictures. There were no graft failure, no immediate stenosis and no fistula. An oral diet was started between days 8 and 16, with an average of 9 days and median of 8 days. Patients left the hospital between days 9 and days 38, with an average of 23.4 days and median of 23 days. This method of reconstruction is advocated as reliable palliative procedure with short-term follow-up. In conclusion, we at Korea Cancer Center Hospital are of the opinion that the free jejunal autograft offers an excellent, safe and relative easy method of the pharyngeal and cervical esophageal reconstruction with significant advantages over other techiques.